Provider Demographics
NPI:1407218233
Name:FIENMAN, ZOE (RDN)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:FIENMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 ANN DR
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6175
Mailing Address - Country:US
Mailing Address - Phone:267-269-5258
Mailing Address - Fax:
Practice Address - Street 1:934 ANN DR
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6175
Practice Address - Country:US
Practice Address - Phone:267-269-5258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005487133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered